Wednesday, October 19, 2011


So, what goes on in marital therapy? you may be wondering. Or maybe you're already in marriage therapy so you kind of know, but let me start from the beginning. When I first meet a couple, I am doing a quick evaluation of numerous things all at the same time.

Here are the things that I am evaluating:

1.) What stage is this couple in the life cycle? Needless to say, a couple coming in for pre-marital counseling is dealing with different issues then a couple with a new baby or a couple with adolescent kids. Way different.

2.) What are the inter-personal patterns going on between these two people? There are some predictable patterns that couples sometimes fall into - the distancer/pursuer, over-responsible/ under-responsible sometimes known as over-adequate/under-adequate and a fascinating pattern with slightly quaint, out-dated diagnostic labels called the obsessive-compulsive/ hysteric marriage. When I was teaching Northwestern medical students, I remember a student missed their El stop because they were reading an article on this subject and were so fascinated with the concept.

3.)What are the cultural, faith issues that impact this family? I always understand a couple or family within their faith and cultural context. What are the values and strengths in their world view that I can draw on to strengthen the marriage? What is the lens through which they see the world? Is there an interface between each individuals cultural background or world view that is causing problems?

4.) Probably most importantly, what are the issues from each persons family of origin from their own childhood or family of origin that are interfering with the marriage? This is probably the most profound area and one that needs to be interwoven throughout the course of therapy.

5.) I am scanning the couple's recent past for any external crisis. The crisis of infidelity is a marriage crusher. Infidelity requires immediate and intensive attention in the marital therapy process. Surprisingly a marriage can often survive this nightmare. Other terrible crises impacting a marriage might be the death of a family member, terminal illness or unexpected job loss. Marital therapy can help couples process and work through these heart breaking situations together.

I promised you a peek inside the brain of a marriage therapist. There you have it. These are some of the things I am evaluating when I first meet a couple. I will elaborate on these issues in later posts. I promise to make the next post one you can apply to your marriage,


  1. Hi Linda,

    I normally do not participate in blogs of any kind but, I have sparked some curiousity in yours and I look forward to reading more. After all everyone can use some marriage advice thanks.

  2. I love this - what an informative and useful blog. I have been married a long time and it is refreshing to be reminded of how we can only change ourselves and not the other person (how true). On your blog there is a marvelous can-do attitude. I love that approach - unless one works out one's own problems even if you divorce you are likely to run into the same unresolved issues. I will certainly follow your blog.